Living Kingdom Youth Development, Inc.

Primary specialty

Behavior AnalystTaxonomy code 103K00000X

Legal business name

LIVING KINGDOM YOUTH DEVELOPMENT, INC.

Practice address

942 Wide Waters Pkwy
Knightdale, NC 27545-7322

Phone

(919) 752-0800

NPI assigned

Apr 13, 2010

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Mrs. Kimberly Fleetwood

Title

Owner

Phone

(919) 752-0800

Specialties & licenses 1

Addresses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1271116800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1271116800000",
    "number": "1225354517",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "942 WIDE WATERS PKWY",
            "city": "KNIGHTDALE",
            "state": "NC",
            "postal_code": "275457322",
            "telephone_number": "919-752-0800"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "942 WIDE WATERS PKWY",
            "city": "KNIGHTDALE",
            "state": "NC",
            "postal_code": "275457322",
            "telephone_number": "919-752-0800"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LIVING KINGDOM YOUTH DEVELOPMENT, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-04-13",
        "last_updated": "2010-04-13",
        "status": "A",
        "authorized_official_last_name": "FLEETWOOD",
        "authorized_official_first_name": "KIMBERLY",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "919-752-0800",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "103K00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Behavior Analyst",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Behavior Analyst in Knightdale, NC
• Providers in Knightdale, NC by specialty
• Behavior Analyst in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 13, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.